Garay J, Benavent M I, Cuadrados J, Tovar J
An Esp Pediatr. 1978 Nov;11(11):783-8.
Authors report two cases of internal hernia through Treves avascular field defects, at the ileal level and another case in which this mesenteric mishape was incidentally found during operation for intestinal obstruction due to adhesions. In this particular case it can be speculated that the defect could have been the cause of a former neonatal obstruction for which operation did not offer an explanation. This type of internal hernia is one of the rarest in pediatric surgical practice. The clinical picture is that of an intestinal strangulation and therefore diagnosis can hardly be made preoperatively. The ileal terminal location of the strangulated loop can, in their opinion, justify a resection extending to the caecum in order to avoid vascular risks on the anastomosis in spite of the sacrifice of the ileo-cecal valve. The three patients survived. Literature on this topic is briefly reviewed.
作者报告了两例经Treves无血管区缺损形成的内疝病例,均发生在回肠水平,另一例是在因粘连性肠梗阻进行手术时偶然发现这种肠系膜畸形。在这个特殊病例中,可以推测该缺损可能是先前新生儿肠梗阻的原因,而当时的手术并未对此作出解释。这种类型的内疝在小儿外科实践中极为罕见。临床表现为肠绞窄,因此术前很难做出诊断。他们认为,绞窄肠袢位于回肠末端,尽管牺牲了回盲瓣,但为避免吻合口的血管风险,行扩大至盲肠的切除术是合理的。三名患者均存活。本文对该主题的文献进行了简要综述。